胃肠道间质瘤临床病理分析及治疗

Treatment and analysis the clinicopathologic patholog of gastrointestinal stromal tumors

目的探讨胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的临床表现、组织学和免疫组化的特点及治疗方法,提高GIST的临床诊治水平。方法对36例GIST患者的临床资料和病理资料进行回顾性分析,并通过免疫组化方法对标本行CD117、CD34、Actin、S-100进行免疫组化研究。结果本组均手术切除,其中GIST发生部位胃占63.9%(23/36),小肠30.6%(11/36),结直肠5.5%(2/36)。良性15例,潜在恶性3例,恶性18例,CD117阳性表达率97%(35/36)、CD34阳性率25%(9/36)、Actin8.3%(3/36)、S-100 2.8%(1/36)。结论CD117标记阳性是确诊GIST最重要的诊断依据,手术仍是GIST主要治疗手段。

Objective To explore the clinical behavior, morphology, immunohistochemical characteristics and treat methods of gastrointestinal stromal tumors（GIST）, to improve the clinical diagnostic level of GIST. Methods Retrospective analysis was performed over 36 GIST patients based on clinical data and pathological data between Feb. 1993 and Dec. 2004, followed by an immunohistochemical analysis over the specimens using CD117, CD34, Actin and S-100. Results All cases were surgically resected. Among GIST suffering sites, Stomach accounts for 63.9% （23/36）, small intestine 30.6% （ 11/36 ）, colorectum 5.5% （2/36）. 15 cases are benign, 3 are potential malignant and 18 arc malignant. CD117 positive rate is 97% （35/36）, 25% CD34 positive （9/36）, 8.3% Actin positive （3/36） and 28% S-100 positive（1/36）. Conclusion Positive CD117 marker is the most important diagnosis proof in final diagnosis of GIST and surgical treatment is still the main method for GIST therapy.